The chemist and druggist [electronic resource]

92 Pages·1994·16.5 MB·English

by  UBM

CHEMST&
DRUGGIST
The newsweekly for pharmacy January 29, 1994
Boots sue
ex-Crookes
md
for fraud
Pharmacy firm
m wins needle
exchange tender
milIyfHi
Liverpool link
with neighbours
The Top
Seller.
LPCs question
mUupa future format
Tomato& PSNC
Sleak Ilotpol of
Beconase goes
WithMilupa" V "
Milk I milupa
^Z'&iXii**'' Baby Saux' P
, for hayfever
Update on toxic
shock plus
Research Digest
The Top
Innovator.
Script fraud and
We're still right where we wantto be. On top. Milupa is milupa drug abuse sees
thetopsellingbabyfood brand in pharmacies? We'realso
the top innovator in every sector with the recent launch
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atthetop. Telephone:[phone].
700 jobs go in
IMPORTANT: Breastfeedingisbestforababy. Adoctor, midwife,nurse,healthvisitororpharmacist
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m
thatallpreparationinstructionsarefollowedcarefully. 'Source at Nielsen7,.r.iiptmrmacj £12m/cs/o
Taken
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In 1993 sales of Finesse January. The new TV and
through the Independent radio advertising is sure to lift
Pharmacy Trade increased an sales of Finesse even higher.
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CHEMIST& Thisweek
MUGGIST
INCOR&POPRHAATRIMNGACRYETUAPIDLACTHEEMIST VOLUME 241 NO 5917 134th YEAR OF PUBLICATION ISSN 0009-3033
EDITORIAL
Editor:JohnSkelton,MRPharmS
DeputyEditor:PatrickGrice.MRPharmS
ContributingEditor:AdriennedeMont,
MRPharmS
AssistantEditor:JaneFeelv,PhD,
MRPharmS
BusinessEditor:AnnaEvangeli,BSc
TBeecahuntiycaEldiEtdoirt:oSraMraarhiaPuMrucrelrla,y,BAMRPharmS Humberside pharmacists win needle and syringe exchange tender 152
Reporters:JMoarGirainmnees,MMacRPDhonaarlmdS,MRPharmS Ten pharmacies set up non-profit making company to operate scheme
ArtEditor:TonyLamb
Liverpool reaches out to neighbouring LPCs 153
PriceListController:ColinSimpson
Regional conference among plans under discussion
ADVERTISING
AIadnveGretrirsaermdentManager: LPCs to challenge future structure of PSNC at February conference 154
DeputyAdvertisementManager: Herts LPC heads move to look into PSNC's constitution
JuliandeBruxelles
DougMytton A&H take Beconase POM to P for hayfever 159
PaulineBorda
Production:AlexCraven Warner-Lambert handle sales and distribution: orders placed in February for March delivery
AdvertisementDirector:
FrancesShortland
Capital choice for Europe's centre of excellence 166 REGULARS
PlIil.lSHHK
RonSalmon,FRPharmS ABPI director lauds decision to bring EMEA to London
PUBLISHINGDIRECTOR Topical Reflections 155
FelimO'Brien Updates on toxic shock; the ethics of syringe sales i-viii ScriptSpecials 156
PublishedSaturdaysbyBenn
PublicationsLtd,SovereignWay, Steve Chaplin looks at the latest medical research MedicalMatters 156
Tonbridge.Kent,TN9 1RW Counterpoints 160
TTeelleexp:ho9n5e1:3207B3e2nt3o6n44G22 Two pharmacists struck offby Statutory Committee 169 PersonalOpinion 167
Facsimile:0732361534 Committee hears ofcocaine abuse and script fraud
Letters 168
Subscriptions:Home£\00perannum.Over-
seas&Eire£140perannumincludingpostage. Crookes sue former managing director for fraud 172 BusinessNews 173
£2.10percopy(postageextra).
ABC MemberoftheAudit Writ alleges conspiracy to steal, fraud and false accounting ComingEvents 174
BureauofCirculations Classifiedadvertisements 175
in Fisons to lay off700 in major restructuring 174 BusinessLink 181
AUnitedNewspaperspublication Major£100m investment at Holmes Chapel AboutPeople 182
Comment
Theon-costofbetween 16and25percentpaidtoappliance The appliance wholesaler is able to "fund" the scheme
suppliers has for a considerable time been a source of from the generous on-cost he receives, say passing on 15
annoyancetopharmacycontractors. Lastyear(October30) per cent to the pharmacistwhile retaining 10 per cent and
Xrayser, while appreciatingthe need to provide a complete benefitingfrom a higherstockturn. The pharmacistisable
service toall patients, balancedhisprofessional sentiments to offer a comprehensive service without having to pay to
against business pragmatism, and decided he would no do so and the patient is offered a better service.
longer seek to dissuade patients from using mail order The rub is that, according to the PSNC, the scheme may
suppliers for their ostomy scripts. well contravene the pharmacist's contractual under-
Thisisasorrysituationforanypharmacisttofindhimor takings, although this is not the impression the National
herself in, and Xrayser is far from being alone. Pharmaceutical Association has been giving concerned
Obviously anything that could make appliance prescrip- callers. The wh—olesaler feels there is nothing to beworried
tions more attractive financiallywould be welcome, which about legally and for him there may not be.
is why a scheme from an appliance wholesaler in the Whateverthesituation, suchascheme mightneverhave
Midlands is attracting attention (pl53). existed ifthe Department of Health had acted to eradicate
Towards the end oflast year, D. Wardle & Son, who also this remunerationanomalyas it has repeatedlybeen urged
hold an appliance dispensing contract and whose mana- to do. This situation should not escape the attentions of
ging director describes the on-cost discrepancy as Touche Ross, who are currently looking into the system of
"ludicrous", claim to have been approached by a paymentforappliance supplierswithaviewto reportingto
pharmacist customer faced with the same dilemma as the DoH some time after April.
Xrayser. The outcome is ascheme fromwhich, on the face Let us hope they will recommend a more rational
ofit,everyonederivesabenefitexceptforthetaxpayer,who reimbursment policywhichwill obviate the temptation for
ultimatelyendsup footingthe bill.Wordofthe scheme has pharmacists to "bend the rules" to provide a satisfactory
been spreading like wildfire, according to the company. service to patients.
Chemist & Druggist 29 JANUARY 1994 151
GP
struck Humberside pharmacists
off after
pharmacists' win exchange tender
suspicions
A London GP who prescribed Pharmacists participating in The Group's bid beat those of Furtherfundswill beavailable to
nearly 19,000 controlled tablets South Humberside's syringe and two other interested parties. The expandthescheme tomoresites.
and capsules to a single patient needle exchange scheme have fact that the other parties would The current contract will
has been found guilty of serious won abid tooperateand manage require a full-time employee to expire at the end ofMarch 1995,
professional misconduct by the the scheme in its entirety, run the scheme is believed to butmaybe extended byafurther
General Medical Council. including responsibility for have worked in the pharmacists' 12 months.
The Council ordered that the non-pharmacy exchange outlets. favour. All participants will receive
name of Dr Graham Edlin be The victory has been hailed as "The scheme involves three payment in line with PSNC pro-
removed from the register. He the most significant move in experts in their own fields," says posalsandwill be paid quarterly.
has 28 days to appeal. needle exchange schemes, and Tim Cottingham, the Freelance The management team will also
The disciplinary hearing was one that couldactas a model for Group's secretaryand treasurer. be paid foradministrationwork.
told that pharmacists in the the rest ofthe country. He will oversee the financial Pharmacists who work for
Kensington area had become The exchange scheme was aspects, while vice-chairman Dr multiple pharmacies will have
increasingly concerned that the operating for almost two years RodTuckerisresponsiblefordata payment spilt equally between
patient, Mr K, was selling the before Grimsby and Scunthorpe andstatisticsandchairmanColin the company and pharmacy
drugs to addicts. Health Authority decided to put Keenan is training to be a drugs manager.
However, when one worried its management out to tender. counsellor. "Pharmacy managers can re-
pharmacist phoned the doctor at This prompted the ten Grimsby and Scunthorpe HA, fuse to do needle exchange
his home in Wellington Road, St pharmacies involved to form the known as United Health, is pro- schemes," says Mr Cottingham,
John's Wood, to voice his Freelance Group, a non-profit viding funding for the scheme, "and ifthey do wish to do, then
concernsattheover-prescribing, making company, and to submit from purchasing equipment to that should be recognised."
DrEdlinsaid"Iamawareofthat" an application. transaction fees for participants. Training will be provided to
and rangoff. newmembersoftheorganisation
Rosalind Foster, GMC barris- on a one-to-one basis, with
ter, told the hearing that Dr Pharmacists are 'under-used'. another two to three pharmacies
Edlin's prescribing ofTuinal and scheduledtojointheschemethis
Dexedrine stretched from Janu- Select Committee is told month.
ary to July last year. Mr K was They hope to encourage the
prescribed 12,400 Dexedrine and "The community pharmacist is alent of some branded drugs. interest of intravenous drug
about 6,300 Tuinal on NHS and an under-used professional," "If there was a box on the users who have not previously
private prescriptions. Dr Jonathan Shapiro, of the prescription that they could tick been targeted, such as steroid
Miss Foster said that matters Health Services Management toindicatetothepharmacistthat abusers. Itisanticipatedthatthis
cameto lightafterinspectionsby Centre in Birmingham, told theywantitdispensedgenerically. will get underway after Easter.
Royal Pharmaceutical Society members of the House of that would be very helpful."
opfhfaircemracJiaenest iEndgtihnegtKoemnsoifntghtroene CHeoamlmthonlasstSweeleekc.t Committee on •criIbnivnoglvteomaevnotiditnherenpeecaetssiptryeso-f GP budgets
area. She found extremely The Family Health Services patients having to request and
frequent prescriptions for drugs Authority Standing Committee call at their GP's every time a to rise by
for Mr Kon the same date. told the Select Committee: prescription was needed.
Oneofthepharmacistsnoticed "Greater use should be made of • Pharmacological inputintothe 12 per cent
that three of four people were the expertise—and experience of development of practice formu-
waitingoutsidehisshopforMrK pharmacists particularlycom- laries. The Government has increased
to emerge with the drugs. munity pharmacists." • Providing health promotion its allocations to regional health
Mr Andrew Hopton, counsel This could be done in a and advice in collaboration with authorities for medicines
for Dr Edlin, said his client number ofways: other health professionals. The prescribed by GPs bv 12.3 per
accepted that his prescriptions • Introducing legislation to FHSA Standing Committee be- cent for 1994-95.
forMr K had been "irregularand enable community pharmacists lieves this should be encouraged In cash terms, this represents
irresponsible". to generically substitute for as it is "convenient to patients planned spending on drugs and
He added: "Things clearly got prescribed items. Clive Parr and avoids unnecessary GP con- appliances in England of £3.2
out ofcontrol and the doctor fell ofHerefordandWorcester FHSA sultations and NHS drug billion, 20 percent up on 92-93.
intoerrorby not putting his foot said that many family doctors expenditure". Health Minister Dr Brian
down and saying 'no more'." do not know the generic equiv- The role of pharmaceutical Mawhinneysaidthe Government
advisers was endorsed. Mr Parr was determined to ensure pa-
said: "In terms of encouraging tients received the medicines
Professor defends OTC prescribing, they save their theyneeded.Butitwasimportant
move for H antagonists salHaroiweesvoevre,rtahendmoovneeryatghaeiyn.s"aved tuonecroenduocmeic"pirneaspcprriobpirniga"tewhiacnhd,
2 wasnotreturnedtotheFHSAbut he said could be harmful to
"Anxiety over inappropriate before selling OTC H2 antago- to the Treasury, providing little patients and waste resources
self-medication is no more nists should also be applied to incentive to FHSAs to employ which could be used elsewhere.
substantia] for H2 antagonists sales ofantacids," says Professor them. "The NationalAudit Office has:
than for antacids," according to Jones. Proposed additions to the identified areas of wasteful
Professor RogerJones, chairman He cites the advantages of R, Selected List are being initiated practice such as some repeat
of the Primary Care for Gastro- antagonist use: increased on a price basis rather than on prescribing,"DrMawhinneysaid.
enterology Society. awareness of dyspepsia; making clinicalevidence,DrShapirosaid. "Some doctors still prescribe)
Writing in Minis Magazine the condition less "medical" and Expressing misgivings about expensive brand name drugs!
Weekly(January25),hesayscon- encouraging patients to be less the rationale behind additions to where generic alternativeswould
cernthatthedrugswillbeusedin reliant on their GPs: and re- the Selected List, he claimed: be equally effective and accept- a,
patientswith undiagnosed ulcers ducingthenumberofGPconsul- "Nicotine patches have been able to patients."
and cancers is unjustified. Most tations. shown to work but cannot be The Association of the British)
dyspepsiasufferersdonotconsult "OTC availability of H2 prescribed. Topical non-steroidal Pharmaceutical Industry wel-
their GPs about their condition, antagonists seems to offer an anti-inflammatories can be comedthenewsoftheincreaseinl
preferring to self-medicate with appropriate and rational alter- because companies have recently thedrugsbudget.Medicineprices
antacids. native to the relative inconveni- agreed to drop their prices, yet in real terms were now 15 per,
"Perhaps the questions that enceofrepeatedantacidtherapy," they have been shown to have a cent lower than ten years ago,
pharmacistswillbeadvisedtoask he concludes. limited efficacy." they said.
152 Chemist & Druggist 29 JANUARY 19941
Appliance wholesaler scheme which
helps pharmacists questioned by PSIMC adjourned
A scheme in which an appliance contract). The wholesaler sup- lecting the lion's share of new The Halcion libel trial has been
wholesaler uses pharmacists as plies the goods to the pharmacy patients because ofthis, he says. adjournedfor 12daystoallowMr
"agents" for prescription bus- which issues themtothepatient. "The options were to service Justice May, who is hearing the
iness has been attracting The wholesaler forwards the thebusinesscompletelyourselves casewithoutjury,toreadliterally
widespread interest in the West scripttothePricingAuthorityfor or to do so utilising the valuable thousandsofpagesofdocuments
Midlands. reimbursementandpaysthephar- skillsofthe pharmacist," saysMr relating to the case (C&D last
But the Pharmaceutical Ser- macistafeeforactingasanagent Wardle. "We opted for the latter, week, p 117).
vicesNegotiatingCommittee has on their behalf. andhaveaskedeach individual to The documents chronicle
warned that the scheme, which MrWardlesaysthat,atfarashe actas an agent on our behalf. Professor Ian Oswald's re-
would appear to offer benefits to is aware, the scheme breaks no "In return for their input, we examination of 1(1,000 Halcion
patients, pharmacists and the rules.Asnews ofithasspreadon will provide information and all testresults,whichheclaimswere
wholesaler, could be putting the grapevine, the company has theback-upnecessaryforthemto manipulated by the company to
contractors in breach of their beenapproachedbyanincreasing offeran improvedservice totheir disguise the high incidence of
terms ofservice. number ofpharmacy contractor, appliance patients. We also side-effects such as paranoia,
Andrew Wardle, managing he says. Existing customers have provide a professional fee in amnesiaand violent behaviour.
directorofD.Wardle&SonLtd,a been informed of the situation, recognition of the work carried Ihs concerns were first raised
long-established and reputable but Mr Wardle was not prepared out on our behalf." inaletterto TheLancet,repeated
appliance wholesalerwith depots to say how many contractors are But there are concerns about in a BBC Panorama programme
in Stoke-on-Trent, Stroud and now participating in the scheme. the scheme. Steve Axon, PSNC andthen inafrontpagearticle in
Neath, says that last year the The scheme is commercially secretary, says: "There is a the New York Timesin 1992.
company was approached "by a viablebecauseofthehigh level of complex legal issue here and we LastWednesday, the courtwas
pharmacistwhowishedtoremove on-cost paid to appliance con- are takingadvice." told that a meeting was held at
from his business the adverse tractors, which varies from 25 Inthemeantime,heisadvising The Upjohn Company's head-
effect of expensive ostomy pres- down to 15.8 per cent depending that contractors should not get quarters in Michigan in August
criptions". on the number of scripts dis- involved in the scheme until the 1991afterProfOswaldhadvoiced
The company now offers a pensed. matter has been clarified. his concerns in TheLancet.
schemewhich, C&Dunderstands, Mr Wardle says the on-cost "As far as the PSNC is According to a confidential
works as follows: a patient discrepancy is "ludicrous", and concerned,wewishtodetermine electronic internal memo by
submits a script at the phar- that there is an enormous disin- whether there is a breach of the Upjohn executive N.J. Lawrenz,
macy from where it is forwarded centive for pharmacists to stock pharmacist'stermsofserviceand who attended the meeting on
to the appliance wholesaler expensiveappliance items. Direct the Drug Tariff regulations," he behalfofasuperior, thecompany
(who also holds a dispensing mail businesses have been col- says. was fully aware of the data
manipulation,GeoffreyShawQC,
for ProfOswald, told the court.
Liverpool LPC networks Prof Oswald is being sued by
Upjohn over the Panorama pro-
grammeandtheNewYorkTimes
with neighbours article. A top Upjohn executive,
its British-born Dr Roy Drucker, is
also suingthe former Edinburgh
professor after allegedly being
Liverpool Local Pharmaceutical and imaginative debate on a working party to discuss the libelledbyhimintheprogramme.
Committee is taking teamwork multitude ofissues." employment of an experienced Prof Oswald and the BBC deny
one step further by linking with There was also unanimous communitypharmacisttoactasa libel.
neighbouringLPCstofurtherthe support for Liverpool LPCs local liaisonofficerandtomarket Prof Oswald is counter-
interestsofcontractorsunderthe resolution to be presented to the communitypharmacyservicesto claiming for libel against Upjohn
NHS reforms. Pharmaceutical Services Negoti- thepurchasingauthorities in the over comments made about him
The alliance is seeking to atingCommitteeconferencenext Mersey region. in the New York Timesarticle.
establish a working party of month, which asks the PSNC to At the end of the evening, Mr The trial will resume on
committees and organise a employ and resource a national Donoghue said it was time for January31 whenthefirstwitness
regional LPC conference. practice development officer. Mersey pharmacists to start will be Upjohn executive Lee
The initiative was launched at This supportwas reflected ina shaping events rather than Smith.
Liverpool LPCs annual working prioritydecision forthenew LPC reacting to them.
dinner to which the chairmen
and secretaries of neighbouring
LPCswere invited, the aimbeing
to share thoughts on ways of
presenting and marketing their
contractors' talents.
The evening's theme of
"Healthy Alliances" was
introduced in a presentation by
chairman John Donoghue, who
then invited thoughts, views and
ideas from the floor.
A number of decisions and
resolutions were put forward
including:
• establishing a working party
drawn fromall the LPCs present
•engaging contractor pharma-
cists from all sectors to exploit
the opportunities presented by
the NHS reforms
• holding a regional LPC
conference.
LPC secretary Jeremy
Clitherowtold C&D. "Duringthe
course of the evening I was
delighted to see such a vigorous
Chemist & Druggist 29 JANUARY 1994 153
LPCs question future Homoeopathic
products to
PSNC
structure of be registered
A Homoeopathic Registration
Scheme is to be set up covering
The structure and staffing ofthe economist and a social scientist. Essex LPC is asking that the homoeopathic products for
Pharmaceutical Services Negoti- NHS remuneration dominates PSNC putspressure onthe Royal human use, Tom Sackville,
atingCommitteewillcomeunder the agenda at this year's Pharmaceutical Society to make parliamentary secretary for
close scrutinyat thisyear's Local Conference, taking six of the 19 the act of taking in an NHS health, announced thisweek.
Pharmaceutical Committee Con- listed LPC motions. prescription, for dispensing at The Scheme will confirm a
ference, with a number of Redbridge & Waltham Forest another location, an offence product's quality and safety but
motions calling for change. LPC is asking the Conference to against the Code of Conduct for will not determine its efficacy or
Spearheading the move, reconsider an "in profession" Pharmacists. provide therapeutic indications.
Hertfordshire LPC is calling for compensation scheme for As Essex points out, these All registered products will
a working party to be set up pharmacies dispensing more pharmacies have no control over state clearly: "Homoeopathic
to investigate PSNC's constitu- than 500 but less than 1,500 the dispensing and checking of medicinal product without
tion. prescriptions a month, should theprescriptionswhichtheythen approved therapeutic indi-
This working party, reads the theywishtosurrendertheirNHS give out to their customers. cations". The product will also
motion, should be selected from contracts, "thus increasing the Once again the annual PSNC carry a registration number
at least fourmembersofthe LPC profitability of the erstwhile dinner comes up for discussion, (prefixed HR).
Conference who are not elected competitors". with Bolton and Somerset LPCs No homoeopathic products
members of any other pharma- City & East London LPC is both askingthat it be abandoned have been licensed since the
ceutical body. The secretary of asking for additional monies to because ofthe costs. introductionoftheMedicinesAct
the PSNC and one representative cover the cost of attending ThePSNCpointsoutthatLPCs 1968 because of the difficulty of
each of the National Phar- further education courses, and voted last year by 63 to 13 in providing conventional proof of
maceutical Association, the Buckinghamshire LPC is seek- favourofkeepingthedinnerinits efficacy.
Company Chemists Association ing assurances that local welfare currentformat,butpromisesthat Mr Sackville says: "Under this
andelectedmembersofthePSNC milkschemeswillnotbejeopard- anotherpollwill becarriedoutat scheme evidence of quality and
are also to be included. ised bya national scheme. thisyear's Conference. safety is all that is required."
A second motion from
Hertfordshire, already given
coverage in the pharmaceutical Efamol allegations provoke
Press, recommends that the
PSNC chairmanshouldnotserve manufacturers' fury
more than two years, save in
exceptional circumstances, and Manufacturers have hotly con- ones from China, need refining have been no safety problems
inanyeventnotmorethan three tested accusations that borage which removes the natural anti- with their products or any
(C&Dlastweek, pll6). oils and some evening primrose oxidants. reported for competitive pro-
Other motions calling for oils may be making unjustified Recentanalysisof30brandson ducts in the dosages sold in the
change include one from claims and may even be the UKmarketfoundthat27 had UK, they say.
Liverpool LPC which asks the dangerous. lost most of these anti-oxidants. Roche Productssaythere isno
PSNC to appoint and resource a Dr David Horrobin, Efamol's Unrefined Efamol stays stable evidence that borage oil is more
"competent and experienced" chief executive, said last week indefinitely, said Dr Horrobin, likely to lead to thrombosis or
practice development officer. that while Efamol evening whereas the refined oils deteri- heart disease than evening
Barking & Havering LPC has primrose oil had been subject to orate. primrose oil. The study quoted
asked that, in light of the over 200 clinical studies and a Seven Seas have refuted the used 20 to 50 times the recom-
forthcoming changes in the million person years of safety accusations as "theworst kind of mended dose ofborage oil.
strategy of health service experience,thesamewasnottrue mud-slinging". Claims that GLA in evening
pharmacy administration, the for other brands. TheirSuperEveningPrimrose primroseoilwasmoreactivethan
staff of the PSNC should be The results for Efamol could Oil (which also contains borage in borage oil were not supported
modified to incorporate a health notautomaticallybeextrapolated oil) has been on the market for by the data, say Roche, who areI
to other oils, and manufacturers overtenyearsand theysay it has "dismayed" by information
should do their own tests for been subject to rigorous quality "whichwill serveonlytoconfuseI
Pet care efficacy, safetyand quality before control and purity testing. There the consumer".
week May makingclaims, he said.
in The presence of gamma lino-
lenicacidinanoilwasnoproofof Prereg's father gets life
National Pet Care Week will be efficacy, he said. Borage oil wasa
taking place in the first week of good source of GLA but was Derek Fleming was jailed for life morningshediedbuthehadtold
May with the theme "Healthy chemically very different from at Leeds Crown Court last her they would discuss them
pets, healthy people". Efamol. Recent independent Tuesday for the murder of later. He claims she gave him a
The Week has been study in Nutrition Research had his preregistration pharmacist violentpushandshouted:"That's
incorporated as a limited com- shownthatborageoilencouraged daughter. all you think of, you and youri
pany (in a similar manner to the platelet aggregation. Fleming bludgeoned 23-year- bloodywork."
Pharmacy Healthcare Scheme) Although the study involved old Linda to death with a lump Fleming said: "I rememebr!
by the four participating organi- only six people, Dr Horrobin hammer in the utility room of going back towards Linda and
sations,the Royal Pharmaceutical believesitshouldactasawarning their home onJanuary 22, 1993. remember my left hand beingon;
Society, the British Veterinary aboutpossiblelong-termdangers. He then bundled her body intoa Linda's shoulder and my right!
Association, the Pet Food "Iam concerned that ifunsafe bag and dumped it in a roadside handswingingover. IacceptIhit|
Manufacturers Association and oilsare used, itwill bringall GLA ditch on remote moorland. Lindawith the lump hammer."
the National Office of Animal products intodisrepute," hesaid. During the hunt for Linda, Fleming denied he had killed;
Health. Dr Horrobin went on to say Fleming took part in a televised Lindaaftershediscoveredhewas
Events will take place locally that GLA is highly susceptible to Press conference when he havinganaffairandwasplanning;
and on a national basis. oxidation to harmful peroxides, a pleaded for her to return home. to run away to Spain with hisj
Information on local events in process which is prevented in Her body was found nine days lover of 16 years, Ann Deardon.
which pharmacists can become nature by stabilising factors in later. Fleming, a joinery firm
involved can be obtained from the seed. Fleming said he did not fully manager,admittedmanslaughter
Floss Slade, secretary, National With Efamol, these stabilising recollect the events surrounding butdeniedmurder.Thejurytook
Pet Care Week, PO Box 101, factorsarenotremovedwhenthe her death. He said in evidence three an a half hours tc:
Northwood, Middlesex HA63RH, oil is extracted. But some oils, thatLindahadbeentryingtotalk unanimously find him guilty o|
tel: [phone]. particularly the poorer quality tohimaboutherproblemsonthe murder.
154 Chemist & Druggist 29 JANUARY 1994
CPP offers existing initiatives or are developing countries.
regional help tcootmalmluynuintsyuitpahbalremafcory. Far toWdhoawti,thmiigtshtusIeasikn,Bhriatsaitnh?at
betterwould be for a little time Or has our enlightened
TheCollegeofPharmacyPractice to be takenwith the decision Governmentat last achieved its
hassetuptwostudygroupsinthe and a continuing campaign in ultimate ambition and reduced
London area and has finalised co-operation with the LPC. us to Third World status?
arrangementsforanexamination These leaflets could also
school in Perth. encourage the public to take Fixed term
Thefirst meetingofthe Ealing responsibility for treating their
groupwillbeonFebruary2atthe own problems by, ifnecessary, chairman a
Pharmacy Department, Ealing purchasing products through
General Hospital at 7pm. For the pharmacy. Ofparticular had idea
details contact Susan Edge on current interest are smoking
081-846 6851 (work). cessation and dietary folic acid
The Central London study supplementation. The amount ofcriticism
group will meet on March 16 at Properly organised, these levelled against the PSNC
the Pharmacy Department, Mid- leaflets have the potential to seems to vary directly with the
dlesex Hospital. For details beneficially promote difficulties experienced in
9co8n4t8act(wNoirckk)Hooorke0r44o2n 027116-437830 cmoosmtmuFnHiStAyspahraerlmoaockyinagndfor nDeegpoatritamtienngtwoifthHetahleth. When
(afTtehrewoPrekr)t.h examination school cnoo-topbeervatiieowne.dBaustantohetyhemrust athcionlglsecatrieongooifnjgolwleyllg,ootdhecyhaarpes
will deal with the supply and bureaucratic imposition — but, when things are going
dispensing of medicines assess- otherwise that is exactly what badly, it's "offwith their
heads"!
amPteerIntttthhweif(lArlMsobusmeers1rhs0aem.yle3dn0tRaoomnAy)at.Floe4bHrpoumsa.priyCtoas1l3t, I tGheyowivll ebecromen. ment aspupbAmrniotaetcxehadmipsblytehHeoefrmttoshtiisLookncnaele-jerk
fisor£2n0onf-omreCmPbPermse.mbers and£30 Chance to ambition woPfhhaiorfcfmhiaccseeeoeufktsitchtaeolPliCSmoNimtCmtichthetapeierermiaond.
achieved?
This chairmanship ofthe
Premises rise display an PSNC requires a political
again in involvement wMsahasandymoaywreraoirfesdh,eagrmop,yrsewosieofnnetawsfaetslefra-I dpeseotxsatsbeelrsiisst.hyItwthhaeilscpoherrfseeoqwuniaorlfesustime to
December I have still to see the eight so slim, in fact, that shewas relationshipswhich allow that
health promotion leaflets worried about anorexia and a chairman to become effective.
The number of premises selected by my family health visit to the doctorbecame The danger in prolonged
registered with the Royal services authority. Yet, evenat necessary. Periactin was appointments is that other
Pharmaceutical Society of Great this stage, we are beingwarned prescribed with miraculous members are unable to gain
BDreicteaimnberrosleastbyyeajrustto froeuarchina bNyegtohteiaPthianrgmaCcoemumtiitctaeleSetorvices wrehseulntso.cScahseiosnlaelptlyliakweakael,ogatbeut, eitxspelefr,iiefnncoetacnhdaltlheengpeods,itciaonn
total of 12,099. The total has beware ofthe "greater than like a horse. Her weight encourage arrogance and
remained over the 12,000 mark eight" requests which exceed rocketed and her problems autocracy.
our statutory obligations (C&D receded. But no committee can
IsinceJuly 1993.
itwriatEdhnign1lg3anwdhpirsleaemwistteehsne mwcoeosrmetmecdhneaclneigtneeg,d JovaenIrfuaItrhayem2e2ai,gshkptei,d1I6t)wo.oduilsdplay one acanrSeuifmnulcbleeyrtshuoofgsgepeasdttaiyeesndtsIPehraivaectin to gdfueontocedtrimcoihnnaaienrftfmesacnto.ifveTtlhhyaetwibqetushatloiuttya
Ifrom the register. In London, probably co-operate ifthe concerned about loss of must be the members ofthe
iwhere figures are recorded approach was constructive. But appetite, and positive benefit committee and it is they who
sideepcarreaatseelyo,fjtuhsetreonwea.s an overall wkhnaotwiinsgmowrhaetitmhpeorFtHanStAihsas in hinasalulstuhaaltlytibmeeenI ahcahvieevreadr.elyBut pmouwsetrcoofnttrhoelirthoewntecnhuareiramnadn.
In Wales, two pharmacies mind. seen it used as an Ifthe chairmanship is forced
commenced trading and there These health promotion antihistamine since the constitutionally to change at
wSceortelanndothedreelewtieornes,nowchhialnegesi.n olepapfolrettsunpirtoyvifdoeracoumnimquuneity dquriotwesisneevserse.problem can be pinrvea-ldueatbelremeixnpeedriinetnecrevaalns,dthen
pharmacists to be actively I now learn that the continuity will be lost. I
involved with their FHSAs in indication forappetite suspect the DoH will be seen to
Shingles promoting pharmacy as well as stimulation has been deleted make even better mincemeat of
health. To this end their style which seems a shame our negotiators than they do at
helpline will be crucial. considering that, in my present.
Many FHSAswill take the experience, that was its only
HleealflpetthoenAsgheidnglaeres laanudncwhiillngbea eofafs-ythwea-yshoeluftlaenafdleptrsowvhiidceh, rDeoalhmusee!exMpelracinkcSrhyaprtipceal&ly that Clairvoyant!
arduvnincienlginaeffrreeompaJtaineunatrtye3l1epuhnotniel arleqtuhioruegmhenstatsi,sfeyiitnhgerthdeuplleigcalate tihneapdprroupgrihaatselbyeeinn suosemde Mbeyenpovwienrdiscaotfepd.roWpehlelccyohmaeve
February 4. have already reduced the price
The move was promoted by a ofZovirax shingles pack from
surveywhich showed that only a £113 to£107.30 (C&DJanuary
'quarterofshinglessuffererswere 22, pl20). It is only 5p less
given written information about Topical than Famvir, still insufficient
:he condition and more than 80 to effectively compete, but the
per cent would welcome a night isyet young!
telephone advice line.
"The lack ofawareness of the
symptoms tends to be one ofthe
'Tiain problems associated with
REFLECTIONS
Tie condition," says Dr Sandv
YlacNair,theLondonGPwhowill
)e manning the advice line
luring office hours. It can be
:alledon 0800 410000.
Ihemist & Druggist 29 JANUARY 1994 155
criptspecials
added
Lescol to lipid-
PSNC news
lowering armamentarium TprhoeblPeSmNs,CtshaeysDtehpaat,rtdmueenttoosfupply
Healthhasagreed thatthe
followingitemsshallbein
Category DofPartVIII ofthe
cLhesocloels,terforlom Slaonwdeorzi,ngis aagneenwt LesEcaoclhtrpeaactkmecnotn.tains details of aLcetsicvoel, lsievveerredirseenaasle,impuanidremrent1,8 MDLaerbbueegtvaeTlarorilinftefabftlraebotlsmetBJsaPBn2uPa0r01y3m5g1m;:g;
containing fluvastatin licensed the Riskcheckservice to helpthe years of age, pregnancy, andphenobarbitonetabletsBP
for patients with primary patient modify their lifestyle. breast-feeding lOOmg. Pharmacistsshould
hypercholesterolaemia Product licence holder: Sandoz Precautions: Liver function tests endorsebrand/manufacturerand
(>6.5mmol/Lcholesterol)whodo Pharmaceuticals (UK) Ltd. should be performed before packagainstprescriptionsfor
notadequatelyrespondtodietary Frimley Business Park, Frimley, treatment starts theseitemsotherwise theexisting
control. Fluvastatin is a Camberley, Surrey GU16 5SG Interactions: Bile acid sequest- DrugTariffpricewillbe usedfor
competitive inhibitor of Presentation: Gelatin capsules eringagents, immunosuppressive pricingpurposes.
HMG-CoA reductase, responsible containing 20mg or 40mg flu- drugs IV Axid
for the conversion of HMG-CoA vastatin Side-effects: Unusually mild and
tomevalonate, aprecursorofthe Indications: Primary hyperchol- transient including dyspepsia, Eli Lillyhave launchedan
steBreolfsoreincaludipnagtienctholesbteegrionl.s ensotteardoelqaueamtiealyinrepsaptioenndtstowdhieotadroy nLeaguasleacaatnedgoiryn:soPmOniMa if(nonirtzmrauatlviaedtininoeou)ns.,vTwehhresiicnohnewiosfdAexsiidgnedfor
treatmentwith Lescol,secondary control Packs: Calendar packs of 28 hospitaluse, isavailableasa4ml
causes of hypercholesterolaemia Dosage: The recommended dose capsules 20mg (£14.90) and ampoulecontaining lOOmgof
should be excluded and the range is20to40mgonce daily in 40mg (£15.90) nizatidine. Packsoffiveampoules
patient placed on a standard the evening Product licence numbers: 20mg areavailableatadirecthospital
cholesterol-lowering diet which Contraindications: Known sens- PL 0101/0360, 40mg PL 0101/ priceof£5.46. EliLilly&CoLtd.
should be continued during itivity to any component of 0361 Tel:[phone].
Tarivid 200mg tabs
MedicalMatters TheappearanceofTarivid200mg
Manerix not yet Eczema gives tabletsischangingwith
immediateeffect.The Hoechst
poor logonowappearsononesideof
first-line treatment thebreaklineandthe lettersMXI
of ontheotherside.Hoechst
fife PharmaceuticalsLtd.Tel:
Manerix (moclobemide) cannot ated on the Data Sheet. 081-5707712.
yet be recommended as first-line Moclobemide was found to Chronic eczemaadverselyaffects Oruvail 150mg
treatmentfordepression,saysthe have no appreciable effect on personal, sexual and family re-
latest Drug and Therapeutics bodyweight, unliketricyclicsand lationships ofsufferers as well as Rhone-Poulenc Rorerare
Bulletin. traditional MAOIs, both ofwhich causing difficulties in employ- extendingthe rangeofOruvail
i"fniRrtsohtce-hleiUn,Kewlhtarosetalytaemauernn,cthceldfaoitrmhemitdarjisuogra cthaenThceeavuisdBeeunlwcleeeitgichnutrrcgeoannitncl.lyudaevsailtahblaet mtheenTthN,aetsiaosynusarlavesEyucrzveoefmyac9oA2snsdoucsciutabetjdieocbnt.ys pLi1str5d£o0.9dm.uT3cge1tl.:sxR0w2hi83.ot2hn3TehO-7re2uPvb1oaa4usi2lil2ceC.nNacpHsRSuolrpeersrice
depression". But the Consumers suggests moclobemide is prob- revealedthat80percentfelttheir
Association says the value of ably less effective than the older, family life had been affected; half Marcain polyamps
moclobemide inthetreatmentof cheaper tricyclics. believed personal relationships MarcainPolyampSteripack0.75
patients with depressive illness Roche say the Bulletin article were affected; and 60 per cent percentisanewpresentationof
cannot be judged until the drug appears tobe "biased in favourof stated that their sex lives had bupivacainehydrochloride.The
has beencomparedwith tricyclic the tricyclic antidepressants". suffered. unbreakablepolypropylene
antidepressants in the full dose They further state "the Eczemaalso influenced career ampouleswithanopeningtag
range. conclusion that moclobemide decisions, with young men and allowastandardLuer/Iockfit
Moclobemide is a reversible should not be used as first-line middle-aged women being most syringe tobeattachedtothe
inhibitor of monoamine oxidase treatment and the suggestion affected. Some 42 per cent a1m0pxou1l0em.lIt(£i1s9a.v0a1i)l.abMlaericnaiunnitsof
A, which preferentially breaks that the TCAs are more effective estimated their loss ofincome in Steripack0.75percentinaglass
down serotonin (5-HT) and nor- is unjustified based on available the pastyear because ofthe con- ampoulehasbeendiscontinued.
adrenaline aswell as dopamine. evidence." dition tobeanaverage of£7,236. AstraPharmaceuticals.Tel:0923
Compared with traditional 266191.
MAOIs, interactions between
moclobemide and food Mediterranean diet for Metenix cartons
(tyramine) and drugs (opiates, ThecartonsizeofMetenix 100
sympathomimetics) appear less hyperlipidaemia tabletswillbe increasingfrom
likelyand easier to manage. February 1994sothataproduct
druMgo,clsoobemiindteeraicstaiosnhsortc-aanctibneg Athleaockptoifmlaolndgi-ettefromrstthuediterseamtemaennst aplnadcefdibbrey.iInncrtehaeseodtchearr,borheyddurcaetde iPinnhcfalorurmdmaeacdte.iuotHniocelacelahsfsl.ettTecla:n0b8e1-570
avoidediftreatmentisstopped24 of hyperlipidaemia is still not saturated fat was replaced by 7712.
hours before another drug is known. increased unsaturated fat.
given. But a study published in the Both diets significantly Neupogen new C/l
The Bulletin reported that British Medical Journal investi- decreased plasma concentrations Severecongenital neutropenia
therapeutic doses of moclo- gatingtheeffectsofdifferentdiets of LDL cholesterol and trigly- (Kostman'ssyndrome)with
bemide in combination with a on hyperlipidaemic patients con- cerides. The first would be abnormalcytogeneticsisanew
SSRI appear to be safe. But cluded that a Mediterranean-like monotonous, but a combination contra-indication tothe useof
Roche say this is 'not consis- diet is suitable fortreatment. of the two resembles diets con- Neupogen. RocheProductsLtd.
tent with the Manerix product In the first diet, the reduced sumed in areas of Italy where Tel:[phone].
licence and is contraindic- saturated and total fat was re- cardiovascular disease is low.
156 Chemist & Druggist 29 JANUARY 1994
.f heartburn is left untreated, hydrochloric acid m the stomach's contents can cause damage to the oesophagus.
Gaviscon protects the oesophagus by forming a physical alginate barrier which keeps acid m the stomach - where it
works, and away from the sensitive oesophagus lining — where it hurts.
Gaviscon stops acid reflux and relieves the pain ofheartburn Keeps acid where works
it
m not where hurts
8 out of K) patients.1 it
Relieve the pain and reduce the damage caused by heartburn. Recommend Gaviscon.
PrescribingInformation.ActiveIngredients:Liquid SodiumalginateBP500mg,sodiumbicarbonatePh Eur 2r.7mg.calciumcarbonatePh Eur 160mgperlOmJdose Gaviscon2511Tablet MinnieacidHP25l>mg.sodium
bicarbonatePh Eur 85mg,aluminiumhydroxidegelBP50mg,magnesiumtrisilicatePh Eur 125mgpertablet Indications:GavisconLiquid Heartburn,includingheartburnotpregnancy,dyspepsiaassociated with gastric
retlux.hiatusherniaandrefluxoesophagitis Gaviscon23(1 Heartburnandacidindigestion Contra-Indications: Noneknown DosageInstructions:GavisconLiquid Adultsandchildrenover 12 10-20ml,childrenfV-12
5l2i4-q1uti0admbllceotlnsitqa/uiJindsaff>t2ermPmmreooaldlusscaotnddiLuiamctebneOcdneteiNmoGeasv:iGs4ac4vo/insOcH2o55n1X'2Lt5iab0qlueitAddcuoGlnattvsaiisancnsodn1c0hi24lm4d/mr(eo1n1l1o1s3voeGrdaiv1ui2msc2oBntoatb2hl5e0tlsiqtuLoiedbgeaa-nl<d*Cteaawtbleeedgtotfrhoyor:rmosGuoSgfhLlGyaPvairssorcdeouqnucitarreeLdiscugeCanhrci-lefdrreHeeonlduRenerdt:aeirlR1ep2crkiicNteotst:&rleuClcolomlmlmma£en1nd6Pe0rd,od2u1c1Nt1os1tmleL:i£m2i1t08em6dl, _KECKITT~Ly* C/ O"°LMAN
DansomLane,HullHU87DS GAVISCON*andtheswordtccirclesymbolaretrademarks Dateofpreparation: 1/3/93Reference1. ChevrelB (1980)J ha AW Res 8:30f>-302 % C
THE
E45 ASSETS
NOW
ARE MORE
LIQUID
The arrival of new Lotion E45 last April Even more important than advertising is the
has added a lighter touch to the E45 range. quality of the product itself, which makes it
a valuable adjunct to Cream E45.
But there's nothing light about the assault
the new product has mounted on the It's in recognition of this quality that Lotion
therapeutic moisturiser market. E45 was voted Best New Bodycare Product''.
dermatological
moisturising
lotion Supported by £1,000,000 in consumer So make sure you stock new Lotion E45 -
SOOTHfSANDSO^tV5
DIP/SKIN advertising, Lotion E45 already holds a for those customers who prefer their E45
NOH.CKEASr
6% share. assets to be more liquid.
NEW LOTION E45 ESSENTIAL MOISTURE REPLACEMENT
SOURCES 1.NielsenDefinedDrySkinMarket(September/October1993) 2 NewWomanMagazineBeautyAwards,November1993